Epigastrium: What is it? Organs That Compose It, Associated Pains, Diagnosis and Treatment

It is the part of the abdominal wall above the navel.

The epigastrium also called the epigastric region, is in the upper central part of the abdomen. It is located between the costal margins and the subcostal plane.

The epigastrium is one of the nine regions of the abdomen, along with the right and left hypochondria, the right and left lateral regions (lumbar areas or flanks), and the right and left inguinal (or pits), and the umbilical and pubic regions.

Organs that compose it

This area harbors organs such as the stomach, liver, and pancreas. The adrenal glands, the spleen, the first part of the small intestine, and the duodenum are also found.

Pain in the epigastrium

Epigastric pain is the pain or discomfort just below the ribs in the upper abdomen area. It often occurs along with other common symptoms of your digestive system.

Epigastric pain is not always a cause for concern. This condition has many possible reasons, mainly immediately after eating.

Some causes of pain in the epigastric region:


  • Indigestion:  Indigestion usually occurs after eating. When a person eats something, the stomach produces acid to digest the food.
  • Acid reflux and GERD: Acid reflux occurs when the stomach acid used in digestion is supported by the food tube (esophagus). Acid reflux usually causes pain in the chest and throat, commonly known as heartburn.
  • Overeating:  the stomach is very flexible. However, eating more than necessary causes the stomach to expand beyond its average capacity by putting pressure on the organs around the belly and causing epigastric pain.
  • Lactose intolerance: lactose intolerance may be another cause of epigastric pain. People who are lactose intolerant have trouble breaking down lactose, a sugar found in milk and other dairy products.
  • Drink alcohol: moderate consumption is usually not enough to alter the stomach or intestines. However, drinking too much alcohol at one time or too much alcohol for long periods can cause inflammation in the stomach lining.
  • Esophagitis or gastritis:  esophagitis and gastritis can be caused by acid reflux, infections, and irritation of certain medications. Some disorders of the immune system can also cause inflammation.
  • Hiatal hernia a hiatal hernia occurs when part of the stomach pushes up through the diaphragm and into the chest. This may be due to an accident or a weakening of the diaphragm muscles.
  • Peptic ulcer disease:  Symptoms of peptic ulcer disease may include epigastric pain and internal bleeding, such as stomach pain, fatigue, and shortness of breath.
  • Gallbladder Disorder:  Problems with the gallbladder can also cause epigastric pain. Gallstones may be blocking the opening of the gallbladder, or the gallbladder may be inflamed.
  • Pregnancy: It is widespread to feel a slight epigastric pain during pregnancy. This is commonly caused by acid reflux or pressure from the expanding uterus in the abdomen. Changes in hormone levels can also aggravate acid reflux and epigastric pain during pregnancy.


The diagnosis of the cause of epigastric pain is essential to ensure adequate treatment. A health professional will probably ask you questions about pain and any additional symptoms.

If the cause is not clear, they can request tests, which include:

  • Imaging tests, such as X-rays, ultrasound, or endoscopy.
  • Urine tests to detect infections or disorders of the bladder.
  • Blood test.
  • Cardiac tests

Treatment of epigastric pain

The treatment of epigastric pain will vary according to the cause. For example, if overeating often causes epigastric pain, a person may wish to eat smaller portions and make sure they eat foods that they fill, such as lean proteins. They may also want to avoid foods that cause gas.

Conditions like GERD, peptic ulcers, and Barrett’s esophagus may require long-term treatment to control symptoms. A person should work with their doctor to find a treatment plan that works for them.

If a doctor believes that taking certain medications is causing the condition, you may recommend switching to a new drug or reducing the dose.

Over-the-counter or prescribed antacids to help reduce frequent acid reflux and epigastric pain caused by stomach acid may be helpful.